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1、InterrogationQu hongdaconceptionTo know the onset ,development,treatment,present symptoms and other information of disease by questioning patient or accompanying peopleInternal classic Treatise on cold attackThousand worthy prescriptions for emergencepurposeTo know the hobby , custom of patientOnset
2、 development of diseaseJudge the cause and nature of diseaseData from all diagnostic methods should be taken into comprehensive consideration in order to avoid mistake in diagnosisMethod of interrogationSuitable environmentAsk the patient directly Questioning method in emergencyThe doctor should be
3、serious and patient, and be good at thinking and arousing patientsContent of interrogation1.General data: name ,sex occupation,birth place,nationality, address, marriage state,24-solar terms of disease onset, visit data ,admission data Examples:hepatic echinococcosis(包虫病)(pastoral area), rheumatism(
4、风湿病),postpartum disease(产后病)2.Life style and process(Diet, mental activity,regular daily life)3. Family history and anamnesis4.Chief complaint The symptoms the patient feels the most obvious and painfully and the main cause for visiting a doctor. symptoms + period5.History of disease 1)The cause of
5、disease onsetcircumstance,time,symptoms,sudden or not,cause or predisposing cause , development and treatment 2)Present symptoms明代医学家张景岳十问歌:明代医学家张景岳十问歌:明代医学家张景岳十问歌:明代医学家张景岳十问歌:一问寒热二问汗,三问头身四问便,一问寒热二问汗,三问头身四问便,五问饮食六问胸,七聋八渴俱当辨,五问饮食六问胸,七聋八渴俱当辨,九问旧病十问因,再兼服药参机变,九问旧病十问因,再兼服药参机变,妇女尤必问经期,迟速闭崩皆可见,妇女尤必问经期,迟速闭崩
6、皆可见,再添片语告儿科,天花麻疹全占验。再添片语告儿科,天花麻疹全占验。 Cold and fever Aversion to cold Intolerance of coldA. Chill and fever a.more chill than fever b.more fever than chill c.fever with aversion to coldB.the chill and fever seprately a.fever without chill sthenic fever,tidal fever,low grade fever b.intolerance of col
7、d without feverC.Alternate chill and fever a.shaoyang syndrome b.malariasweatingThe action of yang puts on yin makes the sweating.No sweating wind-cold in the exterior yin insufficiencySweating Normal sweating Abnormal sweatingAbnormality of sweating characterA.spontaneous sweatingB.Night sweatingC.
8、profuse sweating heat or coldD.yellow sweating damp-heatE.fighting sweatingF.dying sweatingAbnormality on sweating locationA.hemihidrosis(半身汗)B.head sweatingC.Chest sweatingD.sweating in the palm and soleE.genital sweatingPainMechanism of pain: Stagnation or stasis Innutrition of bodyClassification
9、of pain A. Character of pain B. Location of PainTo distinguish: heat cold excess deficiencypainCharacter of painExcess: sudden onset, severe and, incessant aggravated by pressing Causes: exogenous evils, qi stagnation,blood stasis, phlegm retention ,parasitosis or food retentionDeficiency: occurs gr
10、adually , dull, paroxysmal, relieved by pressingA. Distending pain-qi stagnationB. Stabbing pain-blood stasisC. Colic pain(绞痛)-solid evils obstructionD. Retraction pain(掣痛)malnutrition of tendonsE. Scorching pain(灼痛)fire evilsF. Cold pain-yang deficiency , cold attackG. Hollow paindeficiency of esse
11、nce or bloodH. Dull pain(钝痛)deficiency of painLocation of painA. Headache excess deficiency Occiput radiating to nape -taiyang meridian forehead- yangming meridian bilateral sides -shaoyang meridian vertex - jueyin meridianappendixDizziness or vertigo: No phlegm no vertigo No deficiency no vertigo E
12、xcess-phlegm dampness Deficiency - qi and blood, Ascendant hyperactivity of liver yang , kidney essenceB. General aching(pantalgia) wind-cold, wind-dampness pestilential toxin Insufficiency and disharmony of qi and bloodC. Chest pain lungphlegm-dampness, heat, abscess, yin deficiency heartqi deficie
13、ncy and blood stasis, qi stagnation D. Hypochondriac pain blazing of liver fire shaoyang syndrome blood stasis from sprain or falling down damp-heat suspending fluid retentionE. stomachache stomach cold or heat liver qi stagnation blood stasis spleen yang deficiency spleen yin deficiency F. abdomina
14、l pain cold heat excess deficiency yangming fu syndrome deficient cold of spleen blood stasis in lower jiao cold attack liver meridian parasitosis intestinal abcess G. lumbago kidney yin or yang deficiency blood stasis cold attackH. Pain of limbs(joints) wind, heat ,cold ,dampness 4.Diet and taste i
15、n mouth(饮食与 口味)A. Thirst and drinking(口渴与引水)B. Appetite and food intake(食欲与进食)C. Abnormal taste in mouth(异常口味)A. Thirst and drinkinga. No thirst(口不渴)b. Thirst with profuse drinking and urine(伴多汗) consumptive thirst disease lung stomach heat, kidney yin deficiencyc. Thirst but little drinking(少饮) yin
16、 deficiencydamp-heatfluid-retention blood stasisB.Appetite and food intake食欲与进食To distinguish the yin or yang constitution of bodya. Poor appetite(食欲差) spleen deficiency/dampness/qi stagnation/food injury/pregnancyb.over eating but still feeling hungry(多食易饥) stomach fire/strong stomach and weak sple
17、enc.Hunger without appetite (饥不欲食) stomach yin deficiency d.food addiction(偏嗜) parasitosis/pregnancy/Symptoms relieved after food taking-deficiencySymptoms aggravated after food taking-excess (食后痛减,食后加重)Food drunk(食醉)-spleen deficiencyTo know the developing tendency of diseaseC.Taste in the mouthMor
18、bid taste in the mouth(口味异常)Tastelessness(口淡) deficiency of spleen and stomachSweet taste(口甜)-damp-heat in middle jiaoSour taste(口酸)heat accumulation in liver and stomachBitter taste(口苦)gallbladder heat syndromeSalty taste(口咸)kidney disease5.Defecation and urination二便Defecation is related to large i
19、ntestine/lung /spleen/liver/kidneyUrination is related to bladder/kidney/lung/liverTo know the nature of disease and the funtion of visceraA. defecation(大便)a.stool form(便形): dry stool and dark color-heat in large intestine extremely dry stoolblood or body fluid deficiency loose bowel-deficient cold
20、in spleen hard stool first &loose then-dampness / deficiency alternate dry and loose-stagnation of liver qi undigested food in stool-kidney yang deficiency food retention/ damp-heat in large intestineb.Frequency of defecation(大便次数) constipation(便秘): excessive heat /cold accumulation/ yin or qi blood
21、 deficiency diarrhea(腹泻): spleen deficiency/declining of life gate / fire/food retention/damp-heatc.color of stool(便色): dark yellow stagnated heat in intestine black- far blood red -near blood red and white-dampness in large intestine grayish white-jaundance of damp heatd. feeling of defecation(便感)
22、hot and burning sensation-damp heat unsmooth defecation-liver qi stagnation tenesmus(里急后重)dampheat fecal incontinence(大便失禁)-deficiency of spleen and kidneyUrination(小便)Related to body fluid/lung/spleen/kidney4-6 times a day1500-2000 ml a dayReflect the condition of body fluid/visceraUrination(小便)a.a
23、mount of urine( 尿量) Excessive urine(多尿): kidney yang deficiency consumptive thirst(消渴) kidney yin deficiency Scanty urine(少尿):heat /sweating/vomiting /Diarrhea / deficiency b. frequency of urination Frequent urination(尿频) kidney yang deficiency damp heat in lower jiao dysuria and anuria(癃闭): excess
24、and deficiencyc. color of urine(尿色) normal-light yellow and tranparent yellow-heat, dampheat(jaundice 黄疸) clear-deficiency cold red-collateral impairmentFeeling of urination urethral pain(尿痛) enuresis(遗尿) dripping (淋沥不尽) incontinence(失禁)6.sleepNormal -hiding of yang and flourish of yin (阳潜阴盛则寐)a. In
25、somnia(失眠) 1. Disharmony between the heart and kidney (心肾不交) 2. Deficiency of heart and spleen(心脾两虚) 3. Gallbladder stagnation and phlegm disturbing ( 胆郁痰扰) 4. Food retention(食积)b. Sleepiness(嗜睡) 1. damp-phlegm encumbering in spleen (痰湿困脾) 2.spleen qi deficiency (脾气虚)食醉 3.deficiency of heart and kid
26、ney 4. heat in pericardium(热入心包)7 . Women diseaseA. menstruation( 月经) 5-712-2007.03.12 24-30 B.vaginal discharge(白带)C. pregnancy(怀孕)D.symptoms after delivery(产后症状)A. menstruation( 月经)a.Irregular menstruation(月经不调) preceded menstruation delayed menstruationb.Dysmenorrhea(痛经) 前 中 后c.Amenorrhea and sca
27、nty menses(闭经) congenital (先天的) postnatal(后天的)Metrorrhagia and metrostaxis(崩漏) B.vaginal discharge(白带)Odorless white mucusnormal(正常)White vaginal discharge(色白)Yellow vaginal discharge(色黄)Red vaginal discharge(色红)C. pregnancy(怀孕)Morning sickness(恶阻)Perturbation of fetus(胎动不安)Leakage of fetus(漏胎)Pregn
28、ant edema(子肿)D.symptoms after delivery(产后症状)Lochiorrhea (产后恶漏)Postpartum fever( 产后发热)8.Disease in childrenThe condition after birth(出生后情况)Vaccination /infectious disease(免疫和传染病)The special causes of children disease (小儿特殊情况)What is the aim of interrogation?symptomsTcm procedure of diagnosisEight pri
29、nciple Syndrome differentiationYin and yangExterior-interiorExcessive deficiencyCold -heatVisceral,Meridian,Three-jiaoWei-qi-ying-xueEtiological,Qi-blood andBody fluid Thank you ! 1、字体安装与、字体安装与设置置如果您对PPT模板中的字体风格不满意,可进行批量替换,一次性更改各页面字体。1.在“开始”选项卡中,点击“替换”按钮右侧箭头,选择“替换字体”。(如下图)2.在图“替换”下拉列表中选择要更改字体。(如下图)3.在“替换为”下拉列表中选择替换字体。4.点击“替换”按钮,完成。462、替、替换模板中的模板中的图片片模板中的图片展示页面,您可以根据需要替换这些图片,下面介绍两种替换方法。方法一:更改图片方法一:更改图片1.选中模版中的图片(有些图片与其他对象进行了组合,选择时一定要选中图片本身,而不是组合)。2.单击鼠标右键,选择“更改图片”,选择要替换的图片。(如下图)注意:注意:为防止替换图片发生变形,请使用与原图长宽比例相同的图片。46赠送精美图标